Extrarenal pelvic hydronephrosis: report of five cases

Area of Science:

• Nephrology
• Radiology
• Urology

Background:

• Uretropelvic obstruction can lead to hydronephrosis, a condition where the renal pelvis swells.
• In some cases, the renal pelvis is located outside the kidney (extrarenal).

Observation:

• Five patients presented with uretropelvic obstruction and hydronephrosis, primarily involving an extrarenal pelvis.
• Dilatation of the extrarenal pelvis caused calyceal and infundibular distortion, mimicking an intrarenal mass.
• Renal outline and cortical thickness were better preserved compared to classical hydronephrosis.

Findings:

• Extrarenal pelvis involvement in hydronephrosis can radiographically simulate a solid intrarenal mass.
• Calyceal and infundibular dilatation is less pronounced than in typical hydronephrosis.
• Key imaging features include preserved renal outline and cortical thickness.

Implications:

• Accurate diagnosis of hydronephrosis with extrarenal pelvis requires meticulous radiographic technique.
• Advanced imaging like ultrasonography and arteriography aids in differentiating from solid lesions.
• Distinguishing this condition prevents misdiagnosis and inappropriate surgical intervention.